Elsevier

Urology

Volume 84, Issue 4, October 2014, Pages 815-820
Urology

Infertility
The Association Between Testicular Microlithiasis and Semen Parameters in Chinese Adult Men With Fertility Intention: Experience of 226 Cases

https://doi.org/10.1016/j.urology.2014.03.021Get rights and content

Objective

To investigate the association between testicular microlithiasis (TM) and semen parameters in Chinese adult men with fertility intention.

Materials and methods

We retrospectively reviewed the ultrasonography results of the reproductive system of 16,204 consecutive adult male patients in our hospital with fertility intention from November 2012 to October 2013. TM was diagnosed by scrotal ultrasonography. Patients with TM were divided into classic testicular microlithiasis (CTM) or limited testicular microlithiasis (LTM). The clinical data of CTM, LTM, and non-TM groups, especially of patients in whom sperms were found in semen analysis, were collected and analyzed.

Results

There were 226 men (1.39%) diagnosed with TM. The mean age was 28.96 ± 5.12 years (range, 21-46 years), whereas mean testicular volume was 15.38 ± 4.90 mL (range, 1.62-31.23 mL). CTM and LTM were detected in 141 (62.39%) and 85 patients (37.61%), respectively. Among 200 patients who underwent semen analysis, sperms were found in 159 men (79.5%; 97 men with CTM and 62 men with LTM). One hundred and twenty cases without TM (ie, non-TM group) were collected in the control group. Sperm concentration, total motility, and percentage of progressively motile of CTM, LTM, and non-TM groups was (38.01 ± 31.58 million/mL vs 52.31 ± 33.26 million/mL vs 67.16 ± 36.94 million/mL; P <.001), (46.03 ± 23.69% vs 55.37 ± 24.16% vs 62.08 ± 20.45%; P <.001), and (35.88 ± 20.17% vs 43.15 ± 21.08% vs 47.10 ± 17.84%; P <.001), respectively.

Conclusion

TM is associated with worse semen parameters in adult men with fertility intention. The extent of microlithiasis correlates inversely with semen parameters.

Section snippets

Materials and Methods

We retrospectively reviewed the ultrasonography results of the reproductive system of 16,204 adult men who visited our hospital, a center for reproductive medicine, with fertility intention from November 2012 to October 2013. All these patients had routine scrotal ultrasonography examinations during this period.

Scrotal ultrasonography, operated by experienced sonographers with at least 3-year clinical experience, was performed in longitudinal and transverse sections by using the high-frequency

Results

There were 226 men (1.39%) diagnosed with TM. The mean age, BMI, and bilateral testicular volume were 28.96 ± 5.12 years (range, 21-46 years.), 25.74 ± 4.00 kg/m2 (range, 15.50-42.50 kg/m2), and 15.38 ± 4.90 mL (range, 1.62-31.23 mL), respectively. In total, 74 patients received chromosome examination, whereas 11 patients (14.86%) suffered from chromosomal abnormalities, as (46,XY,qh+) in 4 cases, (46,XY,1qh+), (46, XY, 13 ps+), (45, XY, der(13; 14)(q10; q10)), (45, XY, der(14; 15)(q10; q10)),

Comment

TM, as an uncommon pathologic entity, was first reported by Priebe and Garret in 1970.12 Later, the ultrasonographic appearance was first described by Doherty et al.13 Höbarth et al14 retrospectively reviewed 1710 testicular ultrasonographies performed on adults for a variety of reasons and found 11 cases (0.6%) of TM. As for the ultrasound examination, the incidence is generally accepted to be around 2% in the symptomatic population.15 Our study clearly showed 226 cases diagnosed with TM among

Conclusion

TM is negatively correlated with semen parameters in the population of subfertile men. The extent of microlithiasis correlates inversely with semen parameters (such that CTM presents with worse semen parameters on average than does LTM).

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    Chao Xu and Jin-long Ma contributed equally.

    Financial Disclosure: The authors declare that they have no relevant financial interests.

    Funding Support: This work was supported by funds from the National Key Technology Research and Development Program (2011BAI17B00), the National Basic Research Program of China (973 Program) (2011CB944502), and the “Improving assisted reproductive technology clinical outcome with traditional Chinese drug named Unicorn-pellet” (Shandong University Funding Program No.12220011281307).

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